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Pathophysiology > Asthma and COPD > Flashcards

Asthma and COPD Flashcards

1
Q

What do both Asthma and COPD have in common?

A

These are both obstructive airway diseases.

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2
Q

Which diagnostic test allows us to tell the difference between obstructive and restrictive disorders?

A

Spirometry -FVL reveals it especially.

Cannot blow out as much (VC)

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3
Q

Describe Allergic Asthma

A

Atopy and asthma attacks specific to an allergen

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4
Q

Describe Non-Allergic Asthma

A

No history of allergy/allergen trigger

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5
Q

What is allergic asthma characterised by?

A

-Increased serum IgE

–> An allergen-specific IgE and Eosiniphilia

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6
Q

What is all asthma characterised by?

A

-General airway hyperreactivity to non-specific irritants such as smoke cold air etc

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7
Q

Name some triggers for asthma

A
  • House dust mites
  • Domestic pets
  • Fungi
  • Exposure to occupational chemicals
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8
Q

What is COPD a blanket term for?

A

Emphysema and Bronchitis

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9
Q

How does COPD affect the body?

A
  • Decreased airflow that is not fully reversible

- Breathlessness can progress over years to chronic hyppoxaemic or hypercarbaric respiratory failure

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10
Q

Define emphysema

A

A disease of destruction in distal airways and lung parenchyma

  • Causes alveoli to be destroyed decreasing SA of lung
  • Lungs often lose elasticity
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11
Q

Define Bronchitis

A

A condition of large airway inflammation and remodelling

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12
Q

Describe Emphysema (4)

A
  • Airspaces distal to the terminal bronchiole become enlarged
  • Alveolar walls and capillaries are destroyed
  • Tissue destruction causes Ventilation-Perfusion mismatch
  • Permanent EFFECTS
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13
Q

How can you view the destroyed alveolar walls?

A

High Res MRI and CT imaging

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14
Q

Describe Bronchitis

A
  • Persistent cough

- Sputum production > 3 months of the year for >2 years

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15
Q

What occurs at a cellular level with Bronchitis?

A
  • Neutrophilic inflammation driven by CD8+ T cells
  • Peribronchial fibrosis
  • Increase in airway smooth muscle
  • Airways will be occluded by mucus
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16
Q

What can make COPD progress?

A
  • Smoking
  • Atmospheric Pollution
  • BUT not everyone who smokes gets COPD
  • COPD progresses in some people who give up smoking
17
Q

In what ways do COPD and Asthma merge?

A

inflammation involves neutrophils

and Th1 lymphocytes

18
Q

In what ways do Asthma and COPD merge?

A
  • 10% of COPD patients have reversible bronchoconstriction (like asthma)
  • These COPD patients have elevated numbers of eosinophils (like asthma)
  • These COPD patients respond well to corticosteroids (like asthma)
19
Q

What is the goal with treatment for both?

A

Improve Qol and prevent exercabations

20
Q

What is a key feature of pharmacotherapy?

A

It is stepwise so it has step downs and steps up to match the patients needs

21
Q

What does asthma treatment involve?

A
  • ‘Relievers’ (Such as Beta agonists)
  • ‘preventers’ (such as inhaled corticosteroids)
  • often a combo therapy
22
Q

What does COPD treatment involve?

A

-Initially long acting beta agonists (LABAS) or long acting muscarinic antagonists (LAMAS)

23
Q

What inhaler for Asthma?

A

pMDI metred dose inhalers

such as Ventolin

beta 2 agonist

24
Q

What inhaler for COPD?

A

Dry powder (DPI) LAMA for COPD

Such as Breezhaler

Muscarinic Antagonist

25
Q

Combination inhalers for asthma?

A

Combination Dry Powder Inhalers

  • Seretide/Accuhaler
  • Symbicort

Long-acting Beta 2 agonist
Corticosteroid

26
Q

Dry Powder for COPD?

LABA/ICS

A

Dry Powder LABA/ICS

BREO

B2 agonist
Corticosteroid

27
Q

Dry powder for COPD?

LAMA/LABA/ICS

A

Three drugs:

Trelegy

28
Q

Are any treatments Curative?

A

No

29
Q

What must occur at same time as pharmacotherapy?

A

Smoking Cessation

30
Q

What new introduced therapies are there for severe asthma?

A

Monoclonal Antibody Treatments (anti-IgE and anti-cytokine)

-Injected and expensive

Pathophysiology (16 decks)

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